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Mora P.A.,University of Texas at Arlington | Orsak G.,University of Texas at Arlington | DiBonaventura M.D.,Health Outcomes Practice | Leventhal E.A.,Johnson University
Health Psychology

Objective: Research has shown that self-assessments of health are strong predictors of morbidity and mortality regardless of format (i.e., self or comparative). In this study, the authors examined the relationship between 2 of these health assessments, self-assessed health (SAH) and comparative health (CH). On the basis of social psychological theory, they hypothesized that CH is predictive of health outcomes because it is based on SAH. Additionally, the authors examined whether motivational and dispositional factors influenced CH and whether these factors were able to account for the differences between CH and SAH. Method: Data were obtained from 851 community-dwelling older adults (M 73 years). Participants responded to questionnaires assessing personality characteristics (e.g., trait affectivity, dispositional optimism and pessimism), and health status (e.g., functional limitations). All-cause mortality was tracked for a 10-year period. Results: Correlation and agreement analyses revealed that both judgments had a high degree of similarity. As expected, survival analysis showed that CH predicted mortality but only until SAH was added into the model. Analysis examining the factors that influence CH showed that after controlling for SAH, high levels of trait positive affectivity, low levels of functional limitations, and low levels of fatigue-lack of energy were associated with high CH ratings. Examination of CH-SAH difference scores showed that only participants' age accounted for differences between these 2 judgments. Conclusions: These data revealed that CH judgments were, to a great extent, based on SAH. Results showed that motivational factors influence CH judgments but do not explain the differences between SAH and CH. © 2013 American Psychological Association. Source

Bolge S.C.,Janssen Scientific Affairs LLC | Goren A.,Health Outcomes Practice | Tandon N.,Janssen Scientific Affairs LLC
Patient Preference and Adherence

Objective: To examine reasons why rheumatoid arthritis patients discontinued subcutaneous (SQ) anti-tumor necrosis factor (anti-TNF) treatment in the past 12 months, so as to help inform successful, uninterrupted therapy.Methods: Data were collected in March and April 2011 using self-reported, internet-based questionnaires. Study inclusion criteria comprised: rheumatoid arthritis diagnosis; discontinuation of SQ anti-TNF medication (adalimumab, certolizumab, etanercept, or golimumab) within the past 12 months; aged ≥18 years; United States residency; and consent to participate. Patients reported primary and other reasons for discontinuation of their most recently discontinued anti-TNF.Results: Questionnaires from 250 patients were analyzed; 72.8% were female, 80.8% were white, and median age was 51 years. Patients had discontinued etanercept (n=109), adalimumab (n=98), certolizumab (n=24), or golimumab (n=19) within the past 12 months. When prompted about their primary reason for discontinuation, lack of effectiveness (40.8%) was cited most often, followed by injection experience (18.4%). Combining prompted primary and other reasons for discontinuation, 60.8% of patients reported lack of effectiveness, while 40.8% reported injection experience, which included: pain/burning/discomfort after injection (14.4%); pain/burning/discomfort during injection (13.2%); injection reactions such as redness/swelling after injection (12.4%); dislike of self-injection (11.6%); dislike of frequency of injection (10.4%); and fear of injection/needles (6.8%).Conclusion: From the patient perspective, there are unmet needs with regard to the effectiveness and injection experience associated with SQ anti-TNF medications, which may lead to discontinuation. Treatment options with a better injection experience may address these needs. These results demonstrate the importance of including the patient perspective when making prescribing decisions or payer access and coverage decisions. © 2015 Bolge et al. Source

Vietri J.,Health Outcomes Practice | Prajapati G.,AllSource PPS | El Khoury A.C.,Merck And Co.
BMC Gastroenterology

Background: Few studies have examined the impact of Hepatitis C virus (HCV) infection on patient reported outcomes in Europe. This study was conducted to assess the burden of HCV infection in terms of work productivity loss, activity impairment, health-related quality of life, healthcare resource utilization, and associated costs.Methods: The 2010 European National Health and Wellness Survey (n = 57,805) provided data. Patients reporting HCV infection in France, Germany, the UK, Italy, and Spain were matched to respondents without HCV using propensity scores. Outcome measures included the Work Productivity and Activity Impairment (WPAI) questionnaire and the Medical Outcomes Study Short Form-12 (SF-12v2) questionnaire. Subgroup analyses focused on treatment-naïve patients.Results: HCV Patients (n = 286) had more work impairment (30% vs. 18%, p < .001), more impairment in non-work activities (34% vs. 28%, p < .05), and more annual physician visits per patient (19.8 vs. 13.3, p < .001). Estimated indirect and direct costs were €2,956 (p < .01) and €495 (p < .001) higher than in matched controls, respectively. Health-related quality of life was also lower among HCV patients. Treatment-naïve HCV patients (n = 139) also reported higher work impairment (29% vs. 15%, p < .01), as well as more frequent physician visits (19.5 vs. 12.1, p < .01) than matched controls. Each treatment-naïve HCV infected patient incurred €934 in direct costs vs. €508 (p < .01 in matched controls. Employed treatment-naïve patients reported higher productivity loss per year compared to matched controls (€6,414 vs. €3,642, p < .05).Conclusion: HCV infection in Europe is associated with considerable economic and humanistic burden. This is also true of diagnosed patients who have never been treated for HCV. © 2013 Vietri et al.; licensee BioMed Central Ltd. Source

Goren A.,Health Outcomes Practice | Annunziata K.,Health Outcomes Practice | Schnoll R.A.,University of Pennsylvania | Suaya J.A.,Glaxosmithkline

Aims: With growing recognition of stagnant rates of attempted cigarette smoking cessation, the current study examined demographic and psychometric characteristics associated with successful and attempted smoking cessation in a nationally representative sample. This additional understanding may help target tobacco cessation treatments toward sub-groups of smokers in order to increase attempts to quit smoking. Design, setting, and participants: Data were used from the 2011 U.S. National Health and Wellness Survey (n = 50,000). Measurements: Current smoking status and demographics, health characteristics, comorbidities, and health behaviors. Findings: In 2011, 18%, 29%, and 52% of U.S. adults were current, former, or never smokers, respectively. Over one quarter (27%) of current smokers were attempting to quit. Current smokers (vs. others) were significantly more likely to be poorer, non-Hispanic White, less educated, ages 45-64, and uninsured, and they had fewer health-conscious behaviors (e.g., influenza vaccination, exercise). Attempting quitters vs. current smokers were significantly less likely to be non-Hispanic White and more likely to be younger, educated, insured, non-obese, with family history of chronic obstructive pulmonary disease, and they had more health-conscious behaviors. Conclusions: Smokers, attempting quitters, and successful quitters differ on characteristics that may be useful for targeting and personalizing interventions aiming to increase cessation attempts, likelihood, and sustainability. © 2014 Goren et al. Source

Gupta S.,Health Outcomes Practice | Isherwood G.,Kantar Health | Jones K.,European Federation of Associations of Families of People with Mental Illness | Van Impe K.,Janssen Cilag GmbH
BMC Psychiatry

Research indicates schizophrenia is a cause of burden for patients and caregivers. This study examined health-related quality of life (HRQoL) and comorbidities experienced by informal schizophrenia caregivers compared with non-caregivers and caregivers of adults with other conditions (e.g., Alzheimer's disease, cancer, and stroke). Methods: Data were obtained from the 5EU (France, Germany, Italy, Spain, UK) National Health and Wellness Survey, an online questionnaire that is representative of the total 5EU adult (18+ years) population. Respondents provided information on HRQoL (SF-36v2: mental and physical component summary (MCS, PCS) and SF-6D (health utility) scores), items from the Caregiver Reaction Assessment (strongly disagree to strongly agree) and comorbidities (sleep difficulties, insomnia, pain, headaches, heartburn, anxiety, depression) experienced in the past 12 months. Schizophrenia caregivers (n = 398) were matched to non-caregivers (n = 158,989) and caregivers of other conditions (n = 14,341) on baseline characteristics via propensity scores. Chi-square tests and ANOVAs were used to determine significant differences across groups. Results: The average age of schizophrenia caregivers was 45.3 years (SD = 15.8), and 59.6 % were female. After matching, schizophrenia caregivers reported lower MCS (40.3 vs. 45.9), PCS (46.8 vs. 49.0), and health utilities (0.64 vs. 0.71) compared with non-caregivers (all p < 0.001). Schizophrenia caregivers were more likely to experience sleep difficulties (42.7 % vs. 28.5 %), insomnia (32.4 % vs. 18.5 %), pain (39.7 % vs. 30.4 %), headaches (48.0 % vs. 42.0 %), heartburn (31.7 % vs. 22.9 %), anxiety (37.9 % vs. 23.6 %), and depression (29.4 % vs. 19.4 %) than non-caregivers. Comparing schizophrenia caregivers and other caregivers, schizophrenia caregivers reported lower MCS (40.3 vs. 42.7, p < 0.001), and health utilities (0.64 vs. 0.67, p < 0.001). Schizophrenia caregivers were more likely to experience sleep difficulties, insomnia, pain, and anxiety than other caregivers. Almost 60 % of schizophrenia caregivers agree/strongly agree that caring for the patient is important to them, but only 31.9 % agree/strongly agree that they have the financial resources to provide adequate care. Conclusions: Schizophrenia caregivers reported worse HRQoL than non-caregivers and caregivers of other conditions. Providing care for an adult relative with schizophrenia is important to caregivers, but caregivers need more resources to provide adequate care. Providing informal schizophrenia caregivers with support services to help better manage patients may improve their health status. © 2015 Gupta et al. Source

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